This research focuses on the application of decision theory -specifically multiattribute utility theory - to the evaluation of treatment alternatives in the clinical management of craniofacial anomalies. Clinical measures describing cases in terms of speech quality (articulation, resonance, and phonation), cosmetic appearance and dental occlusion are related to subjective values that scale individual preferences for treatment outcomes. These measures identify, for example, characteristics of speech that are associated with poorer listener perceptions. Current research is focused on group or team decision making representations in which the validity of multiattribute utility formulations will be tested. Actual cases will be selected for study to contrast surgical options or surgical versus non surgical patient care decisions. An extension of a threshold probability concept for comparing treatments with probable costs and benefits is also under development.